Journal
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
Volume 68, Issue 1, Pages 73-80Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAI.0000000000000397
Keywords
metabolic syndrome; HIV; prevalence; changes; ART; body mass index
Categories
Funding
- AIDS Clinical Trials Group of the National Institute for Allergy and Infectious Diseases [AI 68634, AI 38858, AI 68636, AI 38855]
- NHLBI [HL095135 (R01)]
- NIAID [AI27670, AI36214, AI064086 (K24)]
- [U01 AI69419]
- [K24 AI078884]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL095135] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [P30AI036214, U01AI069419, U01AI068634, R01AI127670, UM1AI068634, UM1AI069432, K24AI064086, P30AI050410, U01AI038855, UM1AI068636, U01AI068636, UM1AI069423, K24AI078884, U01AI038858, U01AI027670, UM1AI069419] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [K24DA037101] Funding Source: NIH RePORTER
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Background: Data on changes in metabolic syndrome (MetS) status in HIV-infected adults on antiretroviral therapy (ART) are limited. Methods: MetS was assessed at ART initiation and every 48 weeks on ART in ART-naive HIV-infected individuals from the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT) cohort. MetS, defined using the Adult Treatment Panel III criteria, required at least 3 of the following: elevated fasting glucose, hypertension, elevated waist circumference, elevated triglycerides, low high-density lipoprotein (HDL) cholesterol. Prevalence of MetS and the individual criteria were compared between ART initiation and during follow-up using McNemar test. Results: At ART initiation, 450 (20%) ALLRT participants had MetS. After 96 weeks of ART, 37% of the 411 with MetS at ART initiation and with available data at this time point did not meet the MetS criteria. Among these participants, there was a dramatic decline in the proportion with low HDL (95% versus 26%, P < 0.0001). Among the 63% who continued to meet MetS criteria at week 96, the proportion with >= 4 criteria was higher at week 96 compared to at the time of ART initiation (48% versus 40%, P = 0.03); at week 96, the proportion with high triglycerides was greater (87% versus 69%, P < 0.0001) as was the proportion with high glucose (59% versus 42%, P < 0.0001). Conclusions: One in 5 ART-naive subjects met criteria for MetS at ART initiation. Although more than half of these individuals continued to have MetS after 96 weeks of ART, 37% with MetS at ART initiation no longer met criteria for MetS; this decrease was driven largely by increases in HDL cholesterol.
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